Peshawar: Liaqat Ali is a victim of one of Pakistan`s worst bombings, but his injuries are not visible to the naked eye.
The 47-year-old government clerk and part-time lab assistant was walking home through the grounds of a hospital in the northwest city of Peshawar in the fall of 2009 when he stumbled upon the carnage left by the blast. Scores of bodies were packed into vehicles. Bleeding survivors with missing limbs and severe burns were scattered everywhere.
He has suffered from severe depression and anxiety ever since and is dependent on antidepressants to make it through the day so he can provide for his wife and four children.
Ali`s plight has become increasingly common in Pakistan`s northwest, the main Taliban sanctuary in the country, where psychiatrists estimate millions are suffering post-traumatic stress disorder and other psychological illnesses after years of militant attacks, army offensives and US drone strikes.
Many don`t receive treatment, largely because of an acute shortage of psychiatrists and psychologists.
"I think what we see is only the tip of the iceberg," said Firaz Khan, a psychiatrist at the mental health ward at government-run Lady Reading Hospital in the city of Peshawar, where most of the 40 to 50 patients who come in each day are suffering from violence-related trauma. "Most victims remain at home and are not getting help."
Peshawar is located close to the border of Pakistan`s tribal region, the militant epicenter, and has been a major target for the Taliban since they started their insurgency in earnest in 2007. At times, the city was bombed almost daily.
Violence has fallen significantly in the last 18 months. Fear and anxiety remain.
Ali`s nightmare began on October 28, 2009, when militants detonated a car bomb in a market crowded with women and children. More than 100 people were killed. The dead and wounded he encountered at Lady Reading Hospital on his way home from work are etched in his mind.
"Some of them had lost arms, others legs. Some of them had burned faces," said Ali, becoming visibly disturbed during an interview at a private psychiatric clinic in Peshawar where he was being treated. "So many dead bodies were stuffed in a vehicle, as if they were not humans but slaughtered animals."
Within days, Ali was having trouble sleeping, experiencing flashbacks and intense fear.
"It would come to my mind that everybody will die. The world was going to end," Ali said.
The northwest is filled with similar cases, according to psychiatrists.
A 9-year-old boy suffered PTSD after witnessing a deadly bomb blast in Peshawar. He became irritable, aggressive and said he wanted to kill someone. He couldn`t sleep, had flashbacks and stopped going to school.